Introduction
It can be a difficult experience to know that someone you love and care about has a mental health problem. You may need both information and support to be able to help them now that they are in hospital.
Equally our staff need to work in partnership with you. We need your commitment, expertise and experience to achieve the best results for our patients.
This booklet explains how care is delivered, how carers will be included and how your needs will be met. It gives details of where you can find further support and information.
More detailed information about the specific ward you are visiting can be found in the ward’s welcome booklet. The welcome booklet is also available to patients and other ward visitors and contains information such as visiting and meal times, directions and items that can and cannot be taken onto the ward.
Useful information
This booklet contains information that should be useful to you as a carer of someone staying on a mental health ward. If you have any questions please speak to a member of staff and they will be happy to help. Staff will also fill in details below for you:
- The ward name is:
- Telephone number:
- The Carers Champion for the ward is:
- The Ward Manager is:
- Telephone number:
- The Deputy Ward Manager is:
- Telephone number:
- The Ward Administrator is:
- Telephone number:
- The patients Care Coordinator is:
- Telephone number:
- The patients Primary Nurse is:
- Telephone number:
- The patients Consultant is
- Telephone number:
- The Pharmacy telephone number is:
Other useful contact numbers can be found within the booklet.
Who is a carer?
A carer is usually a family member, partner, friend or neighbour who provides help and support to someone. In this leaflet a carer is described as someone who provides practical and emotional support to a person with a mental health problem. This could be a common condition such as depression, or one of the more severe and enduring mental illnesses such as schizophrenia, bipolar disorder or dementia.
It is important to remember that there is plenty of room for hope and optimism. Being admitted to hospital does not mean that people have to give up the life they are used to and hospital care today aims to enable people to return to normal life as soon as they are able.
How can carers work with ward staff?
Carers are the people who really know the people they care for and your input is needed and valued by our staff.
If you have questions or concerns you can raise these with any member of staff on the ward. However it will probably be most beneficial for you to discuss matters with the person’s primary nurse or the ward’s carer champion. Please ask the ward staff if you don’t know who this is.
You should be able to attend any meetings about the person you support and have someone, either a friend or advocate, to support you if you feel this would help. If a meeting is organised for a time you find difficult you can ask for it to be rearranged.
When someone is ill or distressed they may say they do not want you to be involved in their care. If this happens you can request a private
meeting with any of the relevant professionals, including the Consultant.
You may also find it easier to discuss matters on the phone or by letter before the meeting takes place. Staff cannot always tell you everything because of rules about patient confidentiality, but they must listen to your concerns. You can expect staff not to pass on information you have provided about yourself and / or the patient. In addition, staff will not disclose your opinions to the patient if this will cause problems for you.
Carer’s services
If you are a carer who provides practical and/or emotional support to the person who has been admitted to hospital there is support for you which is free and confidential. Carer’s Services are there to support families who are impacted by a loved ones’ mental health. They are there to make sure you get support, information, advice and guidance.
They can also help you to get a Carers Assessment if you want this.
The person you are caring for doesn’t need to know you are receiving support. Contact your local Carer’s Service for more information on how they can support you. Contact details can be found at the back of this booklet.
Carer assessment
Carers assessments are offered to those whose caring role impacts on their life. It is a legal requirement for carers to be offered an assessment at least once a year. This does not mean that someone is judging how good you are at looking after the person you care for, it is simply a way of making sure that your own needs are looked after.
The assessment examines ways to reduce the stress, worry and demanding workloads that many carers experience. It can be a very useful way of improving the difficult aspects of caring. Please speak to staff if you are not offered a carer assessment soon after the person you care for is admitted to hospital.
How is care organised?
Mental health care is carried out according to the ‘Individual Care Coordination’ process which is often called CPA (Care Programme Approach). Mental health services will assess an individual’s needs, plan ways to meet these, and check that they are being met.
In addition the physical health needs of the patient are assessed to provide an holistic approach to their health care. Person centred care plans are central to providing considerate care at a potentially distressing time.
Recovery
The approach to mental health care is focused on recovery. This might not necessarily mean a complete cure, but rather a personal process of tackling the adverse impact of mental health problems. It involves
personal development and change, a sense of involvement and control over one’s life, cultivating hope and using the support available from others. An important factor in this is the collaboration between the patient, the carer and the professionals. You as a carer are a key figure in this process.
Meetings
You will probably find yourself attending what is called either a ‘review meeting’, a ‘CPA meeting’, or a multidisciplinary meeting’. Multidisciplinary means all the different services that provide care for the patient, for example clinical care, social care, occupational therapy
and pharmacy. These meetings will result in working together to produce a care plan for the patient. Normally carers can be given a copy of this care plan.
If you are unhappy about anything in the care plan, please discuss this with the person responsible for writing it, this is usually the Care Coordinator.
Make sure you feel comfortable enough to express your views at the meetings and do speak to the staff if this is not the case. If you need to say things that are likely to upset the patient, ask staff about the best way to do this outside of the meeting.
Detained patients
Someone who has been sectioned has been detained under the Mental Health Act 1983, either for assessment or to receive treatment for a mental disorder. This is usually under a Section 2, which allows up to 28 days for an assessment, or a Section 3, which allows up to an initial six months for treatment. Patients detained under the Mental Health Act 1983 are referred to as ‘formal’ patients. Those who have not been sectioned are known as ‘informal’ patients. You may be what the law considers the ‘nearest relative’, which is not the same as being next of kin. Being a ‘nearest relative’ gives you certain rights and duties. More information is available on the goverment website under legislation.
Aspects of hospital care
Visiting
Visiting is welcomed in inpatient settings, the Trust is committed to facilitating visits for all patients within its care where possible in line with its policies and procedures. Before attending the unit please you contact the ward and book your visit. This is when the ward procedures should be explained to you.
On arrival to the ward you will be asked to abide with current guidance which may include social distancing rules, the wearing of personal protective equipment (PPE) and handwashing.
Children / Young visitors visiting
Young visitors (a person under the age of 18) cannot visit on the actual ward. However, there is a specific family visiting room available for young visitors. This room is booked in advance; therefore please speak with the ward staff to ensure this room can be booked for you.
Smoking
Lancashire & South Cumbria NHS Foundation Trust is smokefree. On January 5, 2015, we implemented a Nicotine Management Policy. The policy follows guidance from the National Institute for Health and Care Excellence (NICE) which recommends a smokefree setting for all NHS services.
This means that smoking, including the use of any tobacco product or the use of most e-cigarettes, is not allowed anywhere on Trust premises. There are no designated areas for patients, visitors or staff to smoke on the hospital grounds. We ask patients not to smoke whilst in hospital and encourage people to stop smoking with the support of Nicotine Replacement Therapy if required. All patients will be offered support to stop smoking as part of their care.
Items brought onto the wards
Please only bring items that the patient requires for their admission. We cannot guarantee the safe keeping of patient property or be held responsible for the loss of any items, so please do not bring in anything valuable, including jewellery, items such as shaving equipment, etc. We also request that no illicit substances, items that may cause harm are provided to the patients.
Prescribed medicines and phone chargers can present a risk to other patients and we ask you to check with the ward. At our secure mental health hospital Guild Lodge there may be a wider range of items that cannot be brought onto the wards. You will be provided with a list of restricted items before your first visit.
Levels of safe and supportive observations
Positive therapeutic engagement and observation can protect the safety of patients who are at risk of harm. The Trust has a policy and procedure for the different levels of safe and supportive observations.
Safe and supportive observations as a clinical intervention should be therapeutic with care and recovery from crisis at the core. The primary aim of observation should be to engage positively with the patient in order to mitigate any assessed risk that the patient presents to themselves or others.
This intervention should be applied in non-punitive way and should be a supportive intervention during a time of difficult and challenging
experiences for the patient. This is done as unobtrusively as possible and is reviewed on a regular basis by the MDT.
Meaningful engagement
This is the programme of activities offered to patients to help them to recover and move back into the life they want in the community.
Sometimes patients need to be able to focus on these without interruption, so some periods of the day might be ‘protected therapeutic time’ or ‘quiet time’.
Spiritual needs
Within the hospital there is a room to practice faith or just have time away from the ward to reflect and just be. The nursing staff can also arrange for someone to visit the ward from different denominations.
Interpreters / additional needs
Please ask if you need an interpreter to overcome language barriers or have any additional needs.
Medication
It is important that carers understand what medication is being prescribed, what it is for, and what the side effects might be.
You can ask for leaflets about this or obtain information from ward or pharmacy staff.
Discharge and home leave
Planning for discharge from hospital normally starts as soon as a person is admitted and will be discussed at meetings. If the patient is to return to live with you or is given a few days ‘home leave’, you will need to be in agreement with this. There should be enough notice for you to plan for this.
You should also be informed of what support is available to you, such as contact numbers for advice or in case of an emergency. A detained patient will need a Section 17 form to authorise short periods of leave from the hospital.
You should also be informed of the services that will be provided for the patient once they have left the hospital. If the patient is being discharged but does not live with you, you should still make your views known about whether you feel this is the right thing to do.
Care plans are updated to take into account a patients’ discharge and they contain a crisis / relapse plan. A follow up assessment also takes place within seven days of discharge.
In addition to the follow up assessment, patients detained under certain sections of the Mental Health Act will be offered aftercare under Section 117 of the Act. This means support will be given to help people settle back into the community and to prevent them from having to be re-admitted to a mental health ward.
Who will I meet on the ward?
Medical staff
Consultant Psychiatrist
A Consultant Psychiatrist is a trained doctor who specialises in diagnosing and treating people with mental health problems. A consultant psychiatrist will examine the different factors that may have contributed to a mental health problem.
They have overall responsibility for assessment, care and treatment. When admitted to the ward, patients are allocated a Consultant Psychiatrist for the duration of their stay.
Specialist Registrar and Registrar
Specialist registrars and registrars report to the Consultant. They have more responsibility and experience than a junior doctor and are likely to be working towards becoming a Consultant.
Junior Ward Doctors
There are various junior ward doctors who will talk to patients about their mental health and feedback to the consultant and more senior doctors. They can also review any physical health problem and prescribe medication according to the treatment plan. They attend the ward throughout the day and night.
Nursing staff
Matron
The Matron’s role is to ensure that the patients’ experience on the ward is the best it can be. They also ensure that the service develops continually to improve quality of care. They are available to speak with patients and their carers and families. They ensure the 10 key standards of care are maintained, and provide clinical leadership to the wards through role modelling, coaching and supervision.
Ward Manager
On each ward there is a Ward Manager who is a qualified Nurse. Their role is to deal with the day-to-day management of the ward and to ensure that the patients are receiving the care that they require.
Deputy Ward Manager
Each ward also has a Deputy Ward Manager who supports the Ward Manager and takes charge in their absence.
Senior Staff Nurse / Clinical Practitioner
The role of the Clinical Practitioner is to undertake a prompt and detailed assessment of all patients. They carry out a 24 hour screening assessment and liaise with you and the patients care co-ordinator. They discuss an initial treatment plan at a 72 hour review meeting with the doctor. They are also involved in ensuring that the right services are in place when patients are discharged alongside the patients care co-ordinator, to ensure that the transition from hospital to home is as smooth as possible.
Staff Nurse
A Staff Nurse is the general name given to a qualified Nurse. A Nurse specially trained in mental health is also referred to as a Registered Mental Nurse (RMN). A Nurse specially trained in learning disabilities is also referred to as a Registered Nurse - Learning Disability (RNLD). All the Trusts Staff Nurses are RMN or RNLD Nurses. In some areas the wards are also supported with Registered General Nurses (RGN), who assist with the recovery of physical health problems.
Primary Nurses and Nurse Associates
A Primary Nurse is responsible for the nursing care of a patient during their stay. A Nurse Associate will also work with the patient, especially when the Primary Nurse is off-duty. Primary Nurses are sometimes referred to as Named Nurses or Key Nurses. These terms all describe the qualified Nurse specifically responsible for the patient’s nursing care.
Healthcare Assistant / Support Worker
A Healthcare Assistant/Support Worker works with the nurses and other healthcare professionals, helping with treatment and looking after a patient’s comfort and well-being. They are also known as STR Workers and Healthcare Support Workers.
Occupational Therapist
The Occupational Therapists (OTs) work with people to ensure that they are able to manage their daily activities and routines (occupations).
These may include self-care, domestic chores, work and leisure pursuits. They work in groups and with individuals to identify any difficulties in occupation and develop treatment plans to ensure a safe and timely discharge. OTs also work with other staff to provide a range of enjoyable activities on and off the ward that can help improve mental health and speed up recovery.
Physiotherapist
Whether you have exercised regularly, or not at all, you will be encouraged to learn more about the benefits of increasing your physical activity as part of a healthy lifestyle. If you have physical problems which limit you a Physiotherapist can assess and provide advice and treatment. Groups can be accessed following screening by the Physical Health and Leisure Assistant and individual exercise programmes can be provided.
Health and Leisure Coordinator (HLC)
The HLC is responsible for promoting meaningful physical activity, physical health and healthy living. They liaise with the care team who will complete a gym referral. The HLC will then access and prescribe a personal exercise programme. They also support patients who require advice in healthy living, whether it be healthy eating, weight loss, alcohol advice or smoking cessation.
House Keeper
The House keeper assist staff in the delivery of non-clinical patient care. They support the Multi-Disciplinary Team in maintaining a safe clinical environment.
Student Nurse
A Student Nurse is someone who is currently studying towards becoming a qualified nurse.
Advocate
An Advocate is independent of the ward and the Trust. They can listen to you and the patient in confidence. They can speak up for you if you are not happy with the services you, or the patient, are receiving. Advocates can also put you in touch with other people who are able to help you and give you support at meetings.
Approved Mental Health Professional (AMHP)
Created in 2007, this role replaced the Approved Social Worker. Approved Mental Health Professionals can be Social Workers, Community Psychiatric Nurses, Occupational Therapists or Psychologists. They have had additional training to allow them to carry out duties under the Mental Health Act, for example the sectioning of people who need to be admitted to hospital.
Care Coordinator
As part of the Care Programme Approach (CPA), patients are assigned a Care Coordinator. The role of the Care Coordinator is to be the link between those using mental health services and the care team helping them. The Care Coordinator can be any member of the care team. They are your main point of contact if you have any questions or concerns.
Carer Support Worker
All wards have a Carer Support Worker who is a member of staff designated to work directly with carers. They may offer support for newly identified carers and signpost carers to further information and support groups. Care Coordinators also have responsibility for ensuring the involvement of carers.
Cognitive Therapist
Cognitive Therapy is a type of talking therapy based on the idea that how we think (cognitions) affects our emotions and behaviours. Even in difficult circumstances it is often possible to learn ways of changing how we think about ourselves and our lives.
Changing how we think can also change how we feel and behave. Research suggests that this therapy can often be helpful for people recovering from a range of difficulties.
Patients may be referred to a cognitive therapist who may be able to help them to make sense of their difficulties, learn techniques that may help and assess whether you could benefit from a referral for further therapy following discharge.
Dietitian
Dietitians assess the need for assistance with dietary intake, nutritional support or support to manage dietary intake if linked to a medical problem such as diabetes.
Health and Wellbeing Workers
These staff are based on the wards along with occupational Therapists and Therapy Assistants. They work with patients to assist with daily living skills, activities and developing occupational and vocational skills as a need.
Independent Mental Health Advocate (IMHA)
Independent Mental Health Advocates, are specifically for people who are detained or ‘sectioned’ under the Mental Health Act. Patients can also have free help from IMHAs if they are on a supervised community treatment order, guardianship, or their treatment is subject to certain rules. IMHAs can:
- Support patients to receive information about the how Mental Health Act applies to them
- Speak to professionals to ensure a patient’s views are heard
- Receive information and explanations about a patient’s treatment
- Appeal against a section
- Access records relating to the patient’s detention
Patients entitled to help from an IMHA can contact the services themselves, or ask someone else to do this on their behalf.
Peer Facilitator
You may meet a Peer Facilitator on the ward they provide formalised peer support and practical assistance to patients in order for them to regain control over their lives and their own unique recovery process. The Peer Facilitator will come alongside a patient through their recovery journey, and assist them when taking initial steps in a number of areas dependent on the stage of their personal recovery. For example recovery activities, volunteering and considering the initial steps into employment. Peer Support Facilitators engage with patients to show empathy, share experience, inspire hope and promote recovery with the aim of assisting patients to gain and maintain independence in the community.
Pharmacist
A Pharmacist advises doctors on the medicines best suited to a particular patient. Pharmacists are experts in medications.
Physiotherapist
Whether a patient has exercised regularly, or not at all, they will be encouraged to learn more about the benefits of increasing their physical activity as part of a healthy lifestyle. If they have physical problems which limit them a Physiotherapist can assess and provide advice and treatment. Groups can be accessed following screening by the Physical Health and Leisure Assistant and individual exercise programmes can be provided.
Podiatrist
They are a specialist in the diagnosis and care of foot disorders, including medical and surgical treatment.
Psychologist
A Psychologist or Clinical Psychologist uses talking therapies to help patients resolve their problems. They often use a method called Cognitive Behavioural Therapy or Psychotherapy, and both involve talking about feelings and experiences.
Safety and Security (SAS) Worker
The Safety and Security Worker will monitor who enters and leaves the ward. They check the safety of the ward environment and any items brought onto the ward. They are also responsible for allocating passes to patients for leave, after this has been agreed by the multi-disciplinary team.
Shift Leader
The Shift Leader is a registered nurse who has been allocated by the ward sister/charge nurse to be the nurse in charge for that particular shift. They will co-ordinate the shift and allocate tasks according to priority and need, throughout the day.
Social Worker / Psychiatric Social Worker
Social Workers can offer advice and support on practical matters such as day care and accommodation and can link with other services. A Psychiatric Social Worker will work with the patient and their family to offer support in both a crisis situation and in the longer term. An Approved Social Worker is an old role that has been replaced by the Approved Mental Health Professional.
Student Professionals
You will meet students from various professions on the ward, for example, student nurses, doctors or occupational therapists. They are valued as part of the team and learn through talking to patients and carers, practice, teaching and experience.
Ward Administrator
The Ward Administrator supports the smooth administrative running of the ward.
Sources of help and information
National
Caring for Children and young adults up to age 18
Caring for Adults Carers Act 2014, information available on carers UK website
Blackburn and Darwen
Provided by Carers Service, Greenhurst Place, Blackburn, Lancashire, BB2 1NA www.bwdcarers.org.uk/
Tel: 01254 688 440
Blackpool
If you are caring for adults, information and support is information on Blackpool Gov UK website.
Provided by Blackpool Carers Centre Tel: 01253 393 748
Email: admin@blackpoolcarers.org
Lancashire
Caring for children and young adults up to age 18? Information and support is available on Lancashire GOV website. (part of the Special Educational Needs and Disabilities offer)
Help and support is available if you are caring for an adult on Lancashire Gov website.
North and Central Lancashire
Provided by Lancashire Carers Service Tel: 0345 688 7113 option two
Email: enquiries@lancscarers.co.uk
www.n-compass.org.uk/our-services/carers/the-lancashire-carers-service
East Lancashire
(not including BwD please see separate section)
Provided by Carers Link Lancashire Tel: 0345 688 7113 option 1
Email: info@carerslinklancashire.co.uk www.carerslinklancashire.co.uk/
Young Carers support is available on Lancashire gov website.
Cumbria
Caring for children and young adults up to age 18, information available on Cumbria. Gov website
Caring for adults, information available on Cumbria.Gov website
Furness Area
Provided by Furness Carers Hindpool Community Centre, Nelson Street, Barrow-in-Furness, Cumbria LA14 1NF
Tel: 01229 822 822
Email: admin@furnesscarers.co.uk www.furnesscarers.co.uk/
Community Roots
Community Roots was designed to support staff, service users, carers and LSCFT communities with health & wellbeing learning opportunities and social connections.
We work in partnership with experts by experience, experts by profession and many wide ranging partners to share our experiences and learn about living well with mental health and physical health conditions.
The College develops and supports a range of partnerships with external stakeholders.
It identifies opportunities to work with staff teams to promote health and wellbeing messages and supports bids to help VCFS partners gain funding to deliver opportunities across Lancashire and South Cumbria.
For further information telephone 01772 695 365.
Patient Advice and Liaison Service (PALS)
If you have some concerns, questions or need advice on our services, you can contact the Patient Advice and Liaison Service (PALS) on 0800 234 6088 or contact the PALS Team.
Feeling low and need someone to talk to?
Call 0800 915 4640
Monday to Friday 7pm to 11pm Saturday to Sunday 12pm to Midnight
Need urgent help?
Call 0800 953 0110 24 hours a day, seven days a week
This leaflet is available in alternative languages and formats upon request. Please speak to a member of our staff to arrange this.